Organization
MAINEHEALTH
Active
Parent organization
MAINE MEDICAL CENTER
Other names
Maine Children's Cancer Program
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAINE MEDICAL CENTER
Authorized official
LUGENE ANTHONY INZANA (ASSOCIATE CFO)
(207) 662-3538
Entity
Organization
Contact information
Practice address
100 CAMPUS DR, UNIT 107, SCARBOROUGH, ME 04074
(207) 885-7565
(207) 885-7577
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-6562
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
—
—
282N00000X
General Acute Care Hospital
37563
ME
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
02/25/2011
Last updated
12/19/2022
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